Long-Term Outcome in Europe

Despite being one of the leading causes for stroke in pediatric patients, Moyamoya Vasculopathy (MMV) is a rare cerebrovascular disease, especially in non-Asian countries. While the epidemiological and clinical aspects of MMV in Europe were comparable to the North American series, major differences are known when compared to East-Asian countries. The surgical treatment strategies worldwide to prevent ischemia or intracranial hemorrhage include direct, indirect and combined revascularization procedures. The aim of this following chapter was to present long-term outcome results of MMV patients treated in Europe. We analyzed the so far published MMV series with a follow-up period with up to 17 years. Overall, 12 studies reporting surgical results of n = 451 MMV patients in Europe could be included in this chapter. The majority of the patients presented with ischemic symptoms (mean 77.9%, +/− 14.8%), while intracranial hemorrhage occurred only in few cases (mean 10.9%, +/− 15.7%). Overall, 84.0% of the patients were treated surgically (32.8% direct, 20.1% combined, 47.1% indirect revascularization procedures). These patients reached an estimated good outcome in 87.9% of cases with a bypass patency of 96.5% in mean indicating the long-term benefit of the surgical revascularization also in European MMV patients. However, further clinical trials with long-term outcome results of European MMV patients are warranted.